Laser - Fraxel laser

Filling a need

Fractional
resurfacing is a breakthrough in improving the quality of the skin. This revolutionary treatment can be helpful in addressing
many bothersome skin problems such as wrinkles, acne scars, scars, sun damage, brown spots and other skin problems. The true
advantage of the technology is the ability to acheive great results with minimal downtime.

Below
is a patient who allowed treatment of one part of her surgical scar with 3 Fraxel sessions. The treated part of the
scar has partially faded into the skin improving the appearance.

Below is a Dermatology patient before and after 3 Fraxel treatments for her
acne scars.

Below are pictures of a Dermatology patient before and after two Fraxel treatments. Both wrinkles and uneven
skin color are improved.

Below is a patient with acne scars and the effects of sun damage (brown spots and textural changes) after
three Fraxel treatments

Below is
a patient before and 6 months after 5 Fraxel treatments. Collagen remodeling is a slow process and the final result after
Fraxel is best appreciated 6-12 months after the completion of the series. Although the lighting is slightly different (despite
our best efforts), the pictures demonstrate improvement of the scars and pore size.

About the technology

Made possible by the advances in laser communication technology, 125 to 250 microscopic laser beams are delivered
into the skin. Each beam heats both the epidermis and dermis, allowing both superficial and deep treatment. Although 1,000
to 2,000 pulses are delivered in each square centimeter, skin cells between the beams are not affected thereby allowing for
incrediblyquick healing. By treating a whole area such as the face with 3-6 sessions, the whole zone eventually is fully treated.

Side Effects

Most patients experience 1-2 days of swelling, 2-4 days of redness and 4-7 days of flaking. An annoying,
but harmless side effect is a slight bluish tinge for 1-2 days from the remnants of a temporary blue dye that is applied to
the skin immediately pre-treatment. There is minimal discomfort after treatment and patients may apply cosmetics immediately.
The risks of scarring or skin discoloration are extremely low as this technology is very gentle on the skin.

Click
to view healing of a patient undergoing Fraxel treatment.

Alternatives

Fraxel compares very favorably
to other treatments in terms of effectiveness, tolerability and side effects. Alternative treatments exist, however and are
good options for some patients, especially given the patient cost of a Fraxel treatment.

Intense Pulsed Light
/ Fotofacial Pro: Great option to remove most redness and brown spots with minimal downtime. Lower cost of
treatment.Con: Much less wrinkle improvement than Fraxel.

Laser Resurfacing / Chemical Peels / DermabrasionPro: Deep peels are of comparable effectiveness to Fraxel.Con: Effectiveness related to depth of peeling. Deep
peels are like deep skin burns and require 1-2 weeks of healing as the skin is raw and oozes. Increased risk of scars and
infection.

MicrodermabrasionPro: No downtimeCon: Minimal improvement. Minimal to zero
long term results.

Care. I personally see every new patient who visits our office. I am not just
a physician, I am a Board Certified Dermatologist.My goal is, quite simply, to provide the type of dermatologic care which I would seek for my own family.
This is a very important point, sincephysicans often use the phrase "Doctor's Doctor" to refer to those individuals who typically are selected by
physicians themselves for personal care. I am confident that my practice fully meets that definition. This is the type
of 5-star care and service that our patients expect, deserve and receive. I treat every patient the way I would want to be
treated: with courtesy, dignity and respect. I carefully listen to their skin-care concerns and offer a variety of options
including a treatment plan that I believe will give them the best results and the best dermatologist. We also support our
patients with a very fine medical staff . Please take a moment to explore our top of the line winning website. My philosophy
is simple…Experience Counts and Quality Matters. Please allow me to solve your skin
problems. After all, at NYC Dermatology , our philosophy is if you look great you will feel great with gorgeous skin.”

NYC Dermatology is a full service cosmetic dermatology practice under the direction of Dr. Rothfeld. We offer the latest, most innovative
treatments for skin. All of our treatments are customized to your specific needs.

Our mission is to provide high
quality skin care services with minimal downtime to our patients, and to educate our patients on properly maintaining skin
health. We strive to provide education first on the skin care procedures and products we offer, allowing our patients to make
informed decisions about their skin care.

Dr. Gary Rothfeld is a board-certified dermatologist and dermatologic
surgeon who specializes in aesthetic procedures. Dr. Rothfeld cares for all types of skin conditions with a special emphasis
in the areas of cosmetic dermatology and laser surgery. Dr. Rothfeld was raised in New York , and as a young man was
drawn to the performing arts and creative writing. A strict academic upbringing led him into science and medicine instead.
After many years of rigorous training followed by preceptorships and mentorships that added to his skill and experience, Dr.
Rothfeld has found art again. Dr. Rothfeld stands on a foundation of science but is now able to express himself creatively
in the world of aesthetic medicine.

Every patient is a unique palette of conditions, goals and temperament that
require delicate consideration, and sometimes inventive solutions. Dr. Gary Rothfeld is able to provide the entire gamut of
dermatologic services, including medical dermatology, injectables, laser treatments and surgery. This gives him a range of
possibilities when evaluating a patient. Combination treatments are often tailored to provide the patient with results ranging
from subtle to dramatic.

Dr. Rothfeld strives to listen and understand the patient's specific goals and concerns,
and provide them with satisfying results. NYC Dermatology endeavors to make the patient's visit as comfortable and pleasant
as possible, making their best effort to take the pain out of beauty. Dr. Gary Rothfeld and his staff approach their work
with absolute joy and infectious enthusiasm, which is felt throughout his practice.

Trained in Dermatology, NYC Dermatology by Board Certified Dermatologist NY Dermatology Dr. Gary Rothfeld possesses the special knowledge, skills and professional capability that distinguishes him as an outstanding Dermatologist in NYC , Manhattan , New York at NYC Dermatology by Board Certified Dermatologist. Top New York City Dermatologist, Dr. Rothfeld in Manhattan treats
the most difficult cases until the problem clears. Dr. Rothfeld, a Board Certified Dermatologist at NYC Dermatology in
Manhattan, New York is caring, detailed, and meticulous and will never give up until the problem is cleared. Dr. Rothfeld,
a board certified dermatologist in nyc who practices Dermatology in Manhattan, New York has treated many patients in the entertainment and music industry is caring, detailed and meticulous
and will not give up until the condition resolves. Dr. Rothfeld is recognized as one of the best Dermatologists in NYC
by the entertainment industry.

NYC Dermatology is
under the medical supervision of Dr. Gary Rothfeld, a Board Certified Dermatologist. To enhance every aspect of your
skin care, Dr. Rothfeld has personally created a superb line of cosmetic procedures..

NYC
Dermatology by Board Certified Dermatologist Dr. Gary Rothfeld is a board certified NYC Dermatologist
with a New York City office in Manhattan, New York providing expert skin care, dermatology, and
cosmetic dermatology services.

As an expert in the field of dermatology and cosmetic dermatologic
surgery, Dr. Rothfeld is has appeared on national television shows. Dr. Rothfeld has also been quoted in many high
profile national magazines.Our goal at the manhattan office of Board Certified Derrmatologist , Dr.
Gary Rothfeld is to create an atmosphere of professionalism, trust and complete patient satisfaction at the NYC Dermatology
and Cosmetic Surgery Center in Manhattan, New York. Dr. Rothfeld, Dermatology Director of NYC Dermatolgy is a Board
Certified Dermatologist at NYC Dermatology who has treated many patients in the entertainment industry. Schedule an appointment at
our office which provides top of the line expert skin care, dermatology, cosmetic dermatology services,
and advanced dermatology laser treatments for cosmetic needs and medical skin conditions. We offer a full range of services
including surgery for skin cancer, laser hair removal, Botox®, the Fractionated Resurfacing laser, Titan laser, and acne
photodynamic treatments. Our main goal is to provide you with the most effective and advanced treatment. Join the NYC Laser
Center NYC Dermatology Mailing List Our periodic newsletters include exclusive offers, educational articles, as well
as free treatment & product drawings! Email: nycdermatologist@aol.com in our Media office and including different offers and many more. We offer a variety of services from
Botox® to Liposuction . Please contact us with any questions you may have or schedule an appointment online or by phone for
a consultation. Beauty Is Forever! and Dr. Rothfeld at NYC Dermatologist
has over 20 years of experience with his beauty tips.

Sun Protection

Ultraviolet radiation is the major cause of skin cancer, including melanoma. It is important
for everyone to be aware of its damaging effects and take measures to avoid overexposure.

Although many people enjoy
the appearance of tanned skin and think it looks "healthy," tanned skin is damaged skin. The ultraviolet radiation
in sunlight penetrates the deepest layers of the skin where it harms the cells. The body responds by making more pigment (melanin)
to try to protect itself, but the damage has already happened and may be permanent. The more exposure you have to the sun,
the more likely you are to develop skin problems later in life.

Ultraviolet Radiation

The damaging part of sunlight
is called ultraviolet radiation, or UV rays. It is categorized into three types:

UVC rays
(wavelengths = 200 nm to 290 nm) are the shortest and most powerful of the UV rays. UVC is
the most likely to cause cancer if it reaches skin. Fortunately, most of it is absorbed by the ozone layer in our atmosphere.
However, there is concern that a thinning of the ozone layer may be causing more UVC to reach the earth's surface.

UVB
rays (wavelengths = 290 nm to 320 nm) are less damaging than UVC, but more of it penetrates to the earth's surface.
It is the most common cause of sunburn and skin cancer. UVB is particularly strong at the equator, at high elevations, and
during the summer.

UVA rays (wavelengths = 320 nm to 400 nm)
are the least powerful of the UV rays, but they are present all year and can penetrate
windows and clouds.

Sun Protection

The first and more effective way to avoid sun damage is
to stay out of tthe sun as much as possible.

If you cannot avoid being exposed to sunlight,
there are five basic defenses that you should keep in mind when you go outdoors:

Avoid
peak hours of sunlight

Sunscreen

Clothing

Sunglasses

Shade

Avoid Peak Hours of Sunlight (UV Index)

In general, UV rays are the greatest between 10 a.m. and 4 p.m.
It is best to avoid the outdoors during these hours without protection, particularly during summer, in tropical regions, or
at altitude. During this time, you should pay close attention to the appropriate use of sunscreen, clothing, sunglasses, and
shade.

You can obtain an accurate measure of the amount of UV rays in your area by looking
up the Ultraviolet (UV) Index. The UV Index is like a weather forecast. It provides a
report on the amount of damaging UV rays that are expected to affect a region on a particular day. The UV Index changes day
to day according to time of year, cloud cover, atmospheric ozone, and other factors.

The following table is a breakdown
of the UV Index. A high UV Index number means that you are at greater risk of being exposed to ultraviolet radiation. You
should take special care to avoid outdoor exposure to sunlight when the UV Index is moderate or greater.

0 to 2
= Minimal

3 to 4 = Low

5 to 6 = Moderate

7 to 9 = High

10
or more = Very high

The UV Index can be found on our Website or in local
papers, usually in the weather section.

Sunscreen

There are several factors to consider when selecting the right
sunscreen. (See the Sunscreens handout for more information.)

Sun protection
actor (SPF) - Sunscreens are rated by the amount of protection they provide from UVB, measured as the "sun
protection factor" or SPF. Sunscreens with higher SPF provide greater protection from the sun. It is best to use sunscreens
that offer a minimum SPF of 15.

Broad-spectrum sunscreens - It is best to use a sunscreen that can
protect you from both UVA and UVB rays. These are called "broad-spectrum" sunscreens.
Most of the original sunscreens blocked only UVB, but increased awareness of the damage caused by UVA has lead to the
development of ingredients that protect against UVA too. Broad-spectrum sunscreens combine ingredients to provide a product
with greater protection.

Common sunscreen ingredients that provide protection
from UVB rays:

Cinnamates

Octocrylene

PABA (para-aminobenzoic
acid)

Padimate O and Padimate A (Octyl Dimethyl PABA)

Salicylates

Common
sunscreen ingredients that provide protection from UVA rays:

Avobenzone (Parsol 1789)

Benzophenones
(oxybenzone, dioxybenzone, sulisobenzone)

Sunblocks - "Physical"
sunscreen ingredients lie on top of the skin and work by reflecting or scattering UV radiation. They are particularly useful
for people who are sensitive to the ingredients found in other sunscreens. Sunblocks often contain one or more of these ingredients:

Zinc
oxide

Titanium dioxide

Iron oxide

Although past formulations
were unsightly (often leaving a white film on the skin), newer "microfine" formulations are invisible after being
applied. Microfine titanium dioxide is effective at protecting from both UVA and UVB rays.

Water resistance
- Sunscreens are classified as "water-resistant" if they maintain their protection after two 20-minute
immersions in water. They are classified as "waterproof" if they maintain their protection after four 20-minute
immersions. You should seek a water-resistant or waterproof sunscreen if you will be participating in water sports, such as
swimming or water skiing, or will be actively sweating.

However, independent testing has shown many products do not
perform well in the real world. So it remains a good idea to apply sunscreen every time you leave the water, or frequently
if you are actively sweating.

Using a Sunscreen

Sunscreen should be applied
evenly and liberally on all sun-exposed skin within 30 minutes before going outside to give sunscreen time to take effect.
(Sunblocks are effective immediately after being applied.) Sunscreens should be reapplied every two hours or following swimming
or sweating. Apply sunscreen generously and reapply frequently at least every two hours.

The chemicals may lose
effectiveness over time, so it is important to throw away sunscreen that is past its expiration date
or is over two years old.

No sunscreen is 100% effective; take additional measures to avoid the
damaging effects of the sun's rays.

Clothing

Clothing can provide excellent
protection from the sun. However, not all clothing is protective. A thin, wet, white t-shirt will provide almost no protection
from UV rays. When selecting clothes for sun protection, consider the following:

Cover your head, shoulders, arms,
legs, and feet.

Use a hat that is broad-brimmed (brim should be at least four
inches wide).

Wear fabrics that are thicker or with a tight weave; these allow less
sunlight to penetrate the skin.

Wear darker-colored clothes that absorb more UV rays.

Wear clothing
made from nylon or Dacron because it is more protective than cotton.

Avoid remaining
in wet clothes because wet fabric may allow more UV rays to penetrate the skin.

Wash
clothing with chemical absorbers to increase their protectiveness.

Some clothing
comes with a UPF rating that stands for "Ultraviolet Protection Factor." This measures the ability of the fabric
to block UV radiation from penetrating to the skin. A fabric with a UPF 15 allows only 1/15th (6.66%) of the UV radiation
to penetrate your skin as compared to uncovered skin.

Garments fall into 3 categories:

Good
protection: UPF = 15 to 24

Very good protection: UPF = 25 to 39

Excellent
protection: UPF = 40 to 50+

Choose clothing with a UPF rating of at least 15. Keep in mind that the UPF of a
garment will decrease over time as the fabric wears.

Sunglasses

Overexposure to sunlight can cause cataracts
and macular degeneration, a major cause of blindness. Sunglasses can provide protection. However, not all sunglasses are of
value. A darker lens itself does not guarantee protection. Look at the label to ensure that the glasses provide UV protection.
Sunglasses should be large enough to shield your eyes from many angles. Look for sunglasses that are described as blocking
99% or 100% of UVA and UVB. The glasses may also be described as providing UV absorption up to 400 nm.

Shade

If
possible, remain in the shade when outdoors. Keep in mind that shade does not provide full protection from the sun because
UV rays can bounce off reflective surfaces, such as sand, snow, water, concrete, or even porch decks. In addition, some fabrics
used as shade devices, such as parasols or umbrellas, may not provide sufficient protection. If you seek shade under a cloth,
look for a fabric that is thick, tightly woven, and dark-colored.

Clear window glass provides protection from UVC and
UVB, but not UVA rays. If you are frequently exposed to sunlight while driving, the plastic interleaf of your windshield (which
prevents it from shattering) can help block the light, but side windows have no such protection. Non-drivers can make use
of additional window shade devices. Drivers in some states may be able to use darkly-tinted glass in the side windows, but
this is illegal in some states.

Summary

Avoid the sun when its
UV rays are strongest, between 10 a.m. and 4 p.m.

Use a broad-spectrum sunscreen with SPF 15 or greater.
Apply it 30 minutes prior to being exposed to the sun and reapply every two hours. Consider using a water-resistant sunscreen
if you will be active (sweating) or in the water.

Use a sunblock on your lips.

Wear a broad-brimmed hat
when outdoors.

Wear sunglasses.

Wear tightly woven, dark clothing to
cover your arms, legs, and feet.

Stay in the shade when possible.

Avoid
reflective surfaces, such as water or snow.

Avoid sunbathing.

Don't
be fooled by cloudy days since damaging rays can penetrate clouds.